How to Code Post-COVID 19 Recovery Programs
Of all the patients who have recovered from COVID-19, 5-15% suffer from lingering symptoms that persist weeks and even months after they test negative for COVID-191. These “COVID-19 long-haulers” experience dizziness, shortness of breath, headaches, decreased blood oxygen levels, blurry vision, blood clots, fatigue, or mental health issues. To help these recovered patients deal with their lingering symptoms, some healthcare organizations have developed post COVID 19 recovery programs staffed with physicians specifically trained to address these symptoms. More programs of this kind are expected to pop up across the country as the number of COVID-19 cases continue to rise.
The purpose of these post-COVID-19 recovery programs is to provide a variety of specialists and services to patients in a single place. Some programs, like the one at Atlantic Health System in New Jersey, begin with an initial consult with a care coordinator, who will recommend a follow-up visit with a specialist based on the patient’s symptoms1. Atlantic Health System’s program employs physical therapists, cardiologists, pulmonologists, and neurologists1.
The COVID-19 recovery team at Emerson Hospital in Massachusetts includes speech therapists, in addition to physical and occupational therapists, to help patients restore their speech and cognition2. Emerson Hospital’s program also offers telehealth appointments or in-person clinic visits.
Currently, health insurance companies are covering the costs of these post-COVID-19 recovery programs.
How to Code These Recovery Programs
As more of these recovery programs are developed, it’s important for medical coders and billers to know how to code and categories these COVID-19-related medical services. “The most important aspect would be the diagnosis portion of the coding,” Vanessa Youmans, Director, Outpatient & ProFee Services, says. “They would need to follow the sequelae guidelines for COVID-19 if the documentation states ‘previous history of COVID-19.’”
Youmans explains that medical coders would assign the reason for the encounter per guidelines as the first listed diagnosis, followed by code B94.8, “sequelae of other specified infectious and parasitic disease” per AHIMA and AHA’s FAQ on COVID-19 if the disease is part of the previous history (Journal of AHIMA, 2020).
“If COVID-19 is documented as active by the provider, coders would assign the appropriate COVID-19 code,” Youmans says. “For these recovery programs, it would most likely be a sequelae, and COVID-19 would no longer be active, but the documentation would need to specify for accurate reimbursement.”
She clarifies that the CPT code selection for these post-COVID-19 recovery programs would be similar to that of other services. For instance, physical therapists would bill physical therapy codes, and providers would utilize E/M levels. Focus on using the appropriate place of service.
Click here to review how to code COVID-19 screenings, symptoms, vaccinations, and other treatments. If your corporate coding team needs support for these COVID-19 recovery cases, contact YES HIM Consulting’s team of credentialed HIM coding experts.